Thyroid Disease

• Iodine deficiency is the most common cause of hypothyroidism worldwide.
• The most common cause of primary hypothyroidism is atrophy of the thyroid gland.
• Goiter can happen with hyper or hypothyroidism.
• Goiter can occur for nontoxic reasons.
• Thyroiditis is the inflammation of the thyroid gland which is also a frequent cause of goiter.
• Goiter is an enlarged thyroid gland.
• Hyperthyroidism is usually exhibited by symptoms associated with high metabolism.
• Hypothyroidism is usually exhibited by symptoms associated with low metabolism.
• T3 monitoring shows an increase with hyperthyroidism.
• T4 monitoring shows an increase for hyperthyroidism but is low or normal for hypothyroidism.
• Increased TSH levels are for hypothyroidism and are low or normal in hyperthyroidism.
• RAIU is used to distinguish Graves Disease from other forms of thyroiditis.
• Thyroid peroxidase (TPO) is used to detect thyroid antibodies for Hashimoto's.
• Graves disease is an autoimmune disease that can cause goiter and exophthalmos.
• What are risk factors for Graves disease?

  Smoking, genetics, infection, stress.
• What diagnostics are done to assess for Graves?

  T3, T4, RAIU, TPO - to rule out Hashimoto's
• How do nurses care for exophthalmos?

  Medications to reduce swelling (Prednisone, Rituximab or Teprotumumab), eye care for dry eyes.
• What are goals for caring for hyperthyroidism?

  • Reduce fever
  • Replace fluids
  • Reduce Stress
  • Reduce thyroid hormone levels
• What kind of food do you give for hyperthyroidism?

  High calorie (4000 - 5000 calories), high protein, frequent meals, avoid foods that can stimulate the GI tract, avoid caffeine.
• What are anti-thyroid drugs to help with hyperthyroid?

  • Propylthiouracil - 3 time a day, works faster than methimazole and is safe for pregnancy, monitor for fever or sore throat
  • Methimazole - Once a day
  • Improvement begins in 1-2 weeks with results in 6-8 weeks